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Cushings? Please read, i know its long.
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Cushings? Please read, i know its long.

Since December I have had 26pounds of unexplained weight gain.  Along with the unexplained weight gain I have been having horrible night sweats.  I have always worn many clothes and many blankets to bed until a few months ago when i've only used a single blanket and barely wear clothes if any and I sweat like crazy. I'm just drenched at night!! Not normal for me!!! My primary provider put me on gabapentin which has taken my night sweats away but I still have other issues.

My other symptoms besides the weight gain is fatigue (thought it was originally associated with my heavy menses and low iron but have been on iron supplements now and its back in normal range but i'm still tired all the time),  I also have achy knee joints, dry itchy skin (more so than normal), generalized weakness, more frequent headaches, my vision is a little more blurry (i already have bad eyes with a script at 7.5), also I've always had irreg. menses (some heavy , some light, some every month some not).  

I saw an endocrinologist today and he ruled out my thyroid (TSH and T4 is within normal range)  but he said it could be a few things.
First he said it could be that i just need to exercise more which is crazy to me b/c the last 2months I've been exercising WAY more than I ever had and I still continue to gain.  I'm past the point of gaining weight b/c its muscle.  
Second he said it could be b/c I was on steroids for a sinus issue but thats been months and I spoke to a doc who I work with and she said the steroids would be out of my system by now since it was months ago and i was only on a week pack.
Third he said it could be an adrenal issue.  He is having me do a 24hr urine to test my cortisol levels.  If they come back high I will need a CT scan but he said that he doubts it is that b/c it happens in less than 5% of patients.  He mentioned Cushings and an adrenal mass?

Thoughts? Input? Any ideas would be much appreciated!

My thyroid level was checked yesterday and was normal.

Another tidbit to my story is that when we went to the IVF doc he told me that I am in the early stages of perimenopause and my AMH being only 0.6 (very low) for a 27 year old.

Can anyone give me insight to all of this? What tests should I be asking the endocrinologist for? THoughts? Anything? .Stop watching Tweet ..10 Comments Post a Comment . Reported Report SpamAbuseDuplicate
Jul 11, 2012 .To: foreverpoppy9.Just because your thyroid level was within the so-called "normal" range does not mean that all is okay for you.  Please post the thyroid test results and reference ranges so that members can assess the adequacy of your testing and treatment. . Reply Select as best answer . Reported Report SpamAbuseDuplicate
Jul 11, 2012 ..I agree with gimel. My numbers are always in normal range and i have most hypo symptoms. . Reply Select as best answer . Reported Report SpamAbuseDuplicate
Jul 11, 2012 .To: foreverpoppy9.Symptoms of perimenopause include weight gain and night sweats.  Night sweats and weight gain are also possible side effects of antidepressants. Hypothyroidism symptoms include weight gain and hyperthyroidism can cause night sweats.
. Reply Select as best answer . Reported Report SpamAbuseDuplicate
Jul 16, 2012 ..My TSH was 1.63 (range being 0.35-4.50)
My T4 was 0.7 (range being 0.6 -1.2)

Thoughts? . Reply . Reported Report SpamAbuseDuplicate
Jul 16, 2012 ..Also my normal provider gave me gabapentin 400mg to help with the night sweats and i'm happy to say i've been 4 nights free of sweat!!! i even went back under the covers! . Reply . Reported Report SpamAbuseDuplicate
Jul 16, 2012 .To: foreverpoppy9.Your Free T4 is very low in the range.  Middle of the range is better.  You are missing the most important thyroid hormone test, which is Free T3.  Free T3 largely regulates metabolism and many other body functions.  Scientific studies ahve shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.  For those reasons you should always request to be tested for Free T3 and Free T4 (not the same as Total T3 and T4) each time you go in for tests.  If the doctor resists, then you should insist on it and don't take no for an answer.  I expect that you will find that your Free T3 is also low in its range, which is frequently associated with hypothyroidism.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  Many of our members report that symptom relief for them required that Free T3 was adjusted into the upper third of its range and Free T4 adjusted to around the middle of its range.  

When you see the Endo, don't be surprised to hear something different from what I have said.  Many of them have the "Immaculate TSH Belief", by which they only want to test and use TSH to diagnose and treat a hypothyroid patient.  That is wrong.  If they go beyond TSH, it is frequently only Free T4, and then they will use "Reference Range Endocrinology", by which they will tell you that a thyroid test result that falls anywhere within the range is adequate.  That is also wrong.  If you want to see how a good thyroid doctor treats a hypo patient, have a look at this letter that was written by a good thyroid doctor for patients that he sometimes consults with from a distance.  The letter is then sent to the PCP of the patient to help guide treatment.

In the letter, please note this statement, "the ultimate criterion for dose adjustment must always be the clinical response of the patient." . Reply Select as best answer . Reported Report SpamAbuseDuplicate
Jul 16, 2012 .To: all.How long have you been on Gabapentin? Some people gain weight being on that. I gained weight using it for neuropathy pain. I had to be taken off due to water retention. . Reply Select as best answer . Reported Report SpamAbuseDuplicate
Jul 16, 2012 ..I've only had my T3 tested in the past
3.0 (10-2009)
3.2 (8-2009)
3.9 (8-2009)

I've only been on gabapentin for a week.

I think I will email my primary care provider tomorrow morning and ask her why she didn't order a T3. and see if she will so the endo has it wednesday morning.  this is all so fustrating to me! . Reply . Reported Report SpamAbuseDuplicate
Jul 17, 2012 .To: foreverpoppy9.Those T3 tests are too old to be of relevance now.  When you go for testing, make sure it is Free T3 and Free T4, not Total T3 and Total T4.  The totals are somewhat outdated and not nearly as revealing as the Free thyroid hormone tests.    I would even go so far as to question the lab people drawing your blood to make sure they know it is to be the Free, not Totals.  That will avoid possibility of a mistake and the wrong tests.  

While you are there, you should also test for Vitamin A, D, B12 and ferritin.
When all these test results are available, please post results and their reference ranges so that members can help interpret and advise further.
. Reply Select as best answer . Reported Report SpamAbuseDuplicateforeverpoppy9  
1 hour ferritin in feb. 2012 was 10
my ferritin in july 2012 was 18

I saw the endo today and he said there is nothing wrong with my throid.
He is making me do a 24hr urine to look at my cortisol levels.  Most  likely he thinks this is all from my steriod use (really bad sinus infection, went through 4 antibiotics and steroids) and my body doesn't agree with it and is compensating??   or i might have an adrenal issue (cushings or a tumor?)

657231 tn?1453836403
I found your post kinda confusing - so I may have missed things.

I don't think your endo is all that great - CTs are NOT what you order for a pituitary issue - you need a dynamic pituitary MRI so already he is out of his league. One test does not rule Cushing's in or out.

I would find another doctor - and make sure you get copies (as it sounds like you do) of all your testing.

Cushing's is very complex. Pituitary is more common then adrenal then ectopic unless the source is taking steroids. It takes a lot of testing to determine if you are sick and then to determine source.
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